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Umbilical Hernia in Children
Topic OverviewWhat is an umbilical hernia?An umbilical hernia is a bulge out of the abdominal wall within the navel that sometimes contains abdominal tissue, a loop of intestine, fat, or fluid. An umbilical hernia is usually present at birth. But it is often not noticeable until the umbilical cord stump falls off, a few days to a few weeks after birth. Normally, umbilical hernias are not painful or dangerous. Umbilical hernias can vary in size from less than 1 cm (0.4 in.) to more than 4 cm (1.6 in.) across. But they rarely measure more than 2 cm (0.8 in.) across. What causes an umbilical hernia?The ring of muscle and other tissue that forms where blood vessels in the umbilical cord enter a fetus's body is known as the umbilical ring. Normally the umbilical ring closes prior to birth. If it does not, tissue may bulge through the opening or weak spot through the navel. It is not known exactly what prevents complete closure of the umbilical ring, but many factors that affect the developing fetus are probably involved. For example, in premature infants, it may be that the abdominal wall is not fully developed before birth. What are the symptoms?The main symptom of an umbilical hernia is a soft bulge under the skin of the navel. You may be able to push part of the hernia so that it temporarily moves back into the abdomen. The hernia may be more noticeable when your child sits or stands upright or strains abdominal muscles during normal activities such as crying, coughing, or having a bowel movement. How is an umbilical hernia diagnosed?A doctor can usually diagnose an umbilical hernia by examining your child's abdomen and evaluating the size, shape, and appearance of the hernia. How is it treated?Most umbilical hernias close on their own without treatment by the time the child is 5 years old, and usually within the first year of life. Umbilical hernias may close slower in African-American children. Surgery typically is needed to repair an umbilical hernia that has not closed by age 5, because it is unlikely to close on its own. The likelihood that an umbilical hernia will heal on its own depends in part on how large it is. Frequently Asked Questions
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SymptomsThe main symptom of an umbilical hernia is a soft bulge under the skin of the navel, or umbilicus. An umbilical hernia is usually not painful or harmful. An umbilical hernia:
Some umbilical hernias have a large amount of extra skin over them. These are called proboscoid umbilical hernias. Although they are not dangerous, proboscoid hernias usually are more noticeable than other umbilical hernias because of their unusual appearance. Complications of umbilical hernias, such as rupture of the hernia or trapping of the intestines in the hernia sac, are rare. But if they occur, you may notice additional symptoms in your child, such as nausea, vomiting, pain, or redness and swelling within the bulge of the hernia. Exams and TestsA doctor usually diagnoses an umbilical hernia during a physical examination. During the exam, your doctor will pay close attention to:
Your child should be warm, relaxed, and comfortable during the exam. Your doctor may want to evaluate the hernia in various positions and will have you help your child stand, sit, or lie down. Follow-up appointments are important to help your doctor monitor whether the hernia is closing on its own. Treatment OverviewAlmost all umbilical hernias close on their own without treatment, usually by the time the child is 1 year of age. If an umbilical hernia does not close on its own by age 5, surgical repair usually is needed. For more information, see: Types of surgery that may be done include:
Problems caused by umbilical hernia surgery are very rare but may include:
What to Think AboutSurgery to repair an umbilical hernia before a child is 5 years old is usually not necessary. But surgery may be performed earlier if:
Home TreatmentHome treatment is not appropriate for an umbilical hernia. Folk remedies, such as strapping a coin over the hernia or using a band or a strap to try to make it smaller, do not help. These remedies may even make the problem worse, such as by causing an infection or by cutting off the blood supply to the tissue inside the hernia, which could lead to emergency surgery. Your doctor will want to examine your child regularly to see if the hernia has begun to close. Be sure to go to all appointments for these exams and for regular childhood checkups. Also, watch for any signs of complications related to the hernia, such as strangulation, that may require immediate treatment. After surgeryIf surgery is needed to repair an umbilical hernia, home treatment can help your child during recovery. A child who has just had surgery to repair an umbilical hernia will need pain medicine, such as Tylenol, for a couple of days or longer. Follow your doctor's instructions on how to care for the wound until it heals, such as keeping the surgical site clean and dry. Continue to watch the incision area as it heals. Immediately report any signs of infection, such as redness, swelling, pain, drainage, or fever. Be sure to keep all appointments for follow-up exams. Your doctor needs to make sure the area heals properly and that problems do not develop. Other Places To Get HelpOrganization
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